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Robotic single-incision transabdominal and transvaginal surgery: initial experience with intersecting robotic arms
Monika E Hagen1, Oliver J Wagner, Ihsan Inan
1Center for the Future of Surgery, Department of Surgery, University of California at San Diego, CA 92108, USA. MonikaHagen@aol.com
Background:
Single-incision laparoscopic and natural orifice translumenal endoscopic surgery (NOTES) are technically challenging methods. Robotics might have the potential to overcome such hurdles with computer technology.
Methods:
The da Vinci Standard and S System (Intuitive, Sunnyvale, USA) were used in human cadavers and pigs to perform single-incision transabdominal and transvaginal surgery. Robotic arms were crossed and control-switched to achieve intuitive control.
Results:
It was possible to perform robotic single-incision laparoscopy in the typical, intuitive fashion. Transvaginal set-up, including docking of the system and introduction of instruments into the abdominal cavity, was possible but no useful manipulation could be performed.
Conclusions:
While robotic NOTES with the da Vinci surgical system was not successful, robotic single-incision surgery is feasible using the above set-up. This new approach seems to offer the advantages of single-incision surgery while maintaining the intuitive control of robotic surgery. Clinical application appears justified.
